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Hahm EY, Chamadia S, Locascio JJ, et al. Dissociative and analgesic properties of ketamine are independent and unaltered by sevoflurane general anesthesia. Pain Rep. 2021;6(2):e936doi: 10.1097/PR9.0000000000000936.
Hahm, E. Y., Chamadia, S., Locascio, J. J., Pedemonte, J. C., Gitlin, J., Mekonnen, J., Ibala, R., Ethridge, B. R., Colon, K. M., Qu, J., & Akeju, O. (2021). Dissociative and analgesic properties of ketamine are independent and unaltered by sevoflurane general anesthesia. Pain reports, 6(2), e936. https://doi.org/10.1097/PR9.0000000000000936
Hahm, Eunice Y, et al. "Dissociative and analgesic properties of ketamine are independent and unaltered by sevoflurane general anesthesia." Pain reports vol. 6,2 (2021): e936. doi: https://doi.org/10.1097/PR9.0000000000000936
Hahm EY, Chamadia S, Locascio JJ, Pedemonte JC, Gitlin J, Mekonnen J, Ibala R, Ethridge BR, Colon KM, Qu J, Akeju O. Dissociative and analgesic properties of ketamine are independent and unaltered by sevoflurane general anesthesia. Pain Rep. 2021 Jun 03;6(2):e936. doi: 10.1097/PR9.0000000000000936. eCollection 2021. PMID: 34104842; PMCID: PMC8177870.
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Pain Rep. 2021 Jun 03;6(2):e936. doi: 10.1097/PR9.0000000000000936. eCollection 2021.

Dissociative and analgesic properties of ketamine are independent and unaltered by sevoflurane general anesthesia.

Pain reports

Eunice Y Hahm, Shubham Chamadia, Joseph J Locascio, Juan C Pedemonte, Jacob Gitlin, Jennifer Mekonnen, Reine Ibala, Breanna R Ethridge, Katia M Colon, Jason Qu, Oluwaseun Akeju

Affiliations

  1. Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA, USA.
  2. Department of Neurology, Massachusetts General Hospital, Boston, MA, USA.
  3. División de Anestesiología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
  4. Henry and Allison McCance Center for Brain Health, Massachusetts General Hospital, Boston, MA, USA.

PMID: 34104842 PMCID: PMC8177870 DOI: 10.1097/PR9.0000000000000936

Abstract

INTRODUCTION: Ketamine, an anesthetic adjunct, is routinely administered as part of a balanced general anesthetic technique. We recently showed that the acute analgesic and dissociation properties of ketamine are separable to suggest that distinct neural circuits underlie these states.

OBJECTIVE: We aimed to study whether this finding is robust to the substantial neural circuit alterations associated with general anesthesia.

METHODS: We conducted a single-site, open-label, randomized controlled, cross-over study of sevoflurane and sevoflurane-plus-ketamine (SK) general anesthesia in healthy subjects (n = 12). Before and after general anesthesia, we assessed precalibrated cuff pain intensity and nociceptive pain quality as well as dissociation using the Clinician-Administered Dissociative States Scale (CADSS). For statistical inference, we ran a variation of backward elimination repeated-measures analysis of covariance. Models with CADSS as a covariate term were used to assess whether dissociation mediated the effect of ketamine on pain intensity and quality.

RESULTS: Sevoflurane-plus-ketamine general anesthesia was associated with a significant (

CONCLUSIONS: Our findings suggest that the analgesic and dissociation properties of ketamine remain separable despite general anesthesia. Thus, ketamine may be used as a probe to advance our knowledge of dissociation independent pain circuits.

Copyright © 2021 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of The International Association for the Study of Pain.

Keywords: Analgesia; Dissociation; Ketamine; Pain; Sevoflurane

Conflict of interest statement

O. Akeju has received speaker's honoraria from Masimo Corporation and is listed as an inventor on pending patents on EEG monitoring and oral dexmedetomidine assigned to Massachusetts General Hospital.

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